{"hospital_name": "Novant Health New Hanover Regional Medical Center LLC", "last_updated_on": "2026-03-30", "version": "3.0.0", "pid": "3076423186", "rid": "8951", "location_name": ["Novant Health New Hanover Regional Medical Center"], "hospital_address": ["2131 S 17th St, Wilmington, NC 28401"], "type_2_npi": ["1376139139"], "license_information": {"license_number": "H0221", "state": "NC"}, "attestation": {"attestation": "To the best of its knowledge and belief, this 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 in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.", "confirm_attestation": true, "attester_name": "Laurie Whalin"}, "standard_charge_information": [{"description": "\"\"Y SET\"\" TUBING", "code_information": [{"code": "A4719", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 ADMN RSV MONOC ANTB IM NJX", "code_information": [{"code": "96381", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 BOD TEMP >=35.5", "code_information": [{"code": "G9773", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 BODYTEMP >=35.5CW/IN 30MIN", "code_information": [{"code": "4559F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 CC STERILE SYRINGE&NEEDLE", "code_information": [{"code": "A4206", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 EM CORE SESSION", "code_information": [{"code": "G9873", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 MED VISIT IN 24MO", "code_information": [{"code": "G9247", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 OR NO CT SINUS W/IN 90D DX", "code_information": [{"code": "G9354", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "100 INSULIN SYRINGES", "code_information": [{"code": "S8490", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "12-LEAD ECG PERFORMED", "code_information": [{"code": "3120F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1DOSE MENIG VAC BTWN 11 & 13", "code_information": [{"code": "G9414", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST HOSP IP/OBS HIGH 75", "code_information": [{"code": "99223", "type": "CPT"}], "standard_charges": [{"minimum": 3993.0, "maximum": 3993.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3993.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST HOSP IP/OBS HIGH 75", "code_information": [{"code": "99223", "type": "CPT"}, {"code": "762", "type": "RC"}], "standard_charges": [{"minimum": 2759.55, "maximum": 2759.55, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 2759.55, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST HOSP IP/OBS MODERATE 55", "code_information": [{"code": "99222", "type": "CPT"}], "standard_charges": [{"minimum": 3993.0, "maximum": 3993.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3993.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST HOSP IP/OBS MODERATE 55", "code_information": [{"code": "99222", "type": "CPT"}, {"code": "762", "type": "RC"}], "standard_charges": [{"minimum": 2759.55, "maximum": 2759.55, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 2759.55, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST HOSP IP/OBS SF/LOW 40", "code_information": [{"code": "99221", "type": "CPT"}], "standard_charges": [{"minimum": 3993.0, "maximum": 3993.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3993.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST HOSP IP/OBS SF/LOW 40", "code_information": [{"code": "99221", "type": "CPT"}, {"code": "762", "type": "RC"}], "standard_charges": [{"minimum": 2759.55, "maximum": 2759.55, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 2759.55, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST NF CARE HIGH MDM 50", "code_information": [{"code": "99306", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST NF CARE MODERATE MDM 35", "code_information": [{"code": "99305", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST NF CARE SF/LOW MDM 25", "code_information": [{"code": "99304", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST PLMT DRUG ELUT OC INS", "code_information": [{"code": "444T", "type": "CPT"}], "standard_charges": [{"minimum": 361.0, "maximum": 361.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST PSYC COLLAB CARE MGMT", "code_information": [{"code": "99492", "type": "CPT"}], "standard_charges": [{"minimum": 99.71, "maximum": 203.48, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 104.28, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 141.65, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 104.79, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 99.71, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 106.83, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 203.48, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 103.77, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 103.77, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST/SBSQ PSYC COLLAB CARE", "code_information": [{"code": "99494", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 CC STERILE SYRINGE&NEEDLE", "code_information": [{"code": "A4207", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM CORE MS MO 10-12 NO WL", "code_information": [{"code": "G9877", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM CORE MS MO 10-12 WL", "code_information": [{"code": "G9879", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM CORE MS MO 7-9 NO WL", "code_information": [{"code": "G9876", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM CORE MS MO 7-9 WL", "code_information": [{"code": "G9878", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM ONGOING MS MO 13-15 WL", "code_information": [{"code": "G9882", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM ONGOING MS MO 16-18 WL", "code_information": [{"code": "G9883", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM ONGOING MS MO 19-21 WL", "code_information": [{"code": "G9884", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM ONGOING MS MO 22-24 WL", "code_information": [{"code": "G9885", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2+ ANTI-HYPRTNSV AGENTS TKN", "code_information": [{"code": "4145F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2+ ANTIPSY SCHIZ", "code_information": [{"code": "G0032", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2+ BENZO SEIZ", "code_information": [{"code": "G0033", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "20+ CC SYRINGE ONLY", "code_information": [{"code": "A4213", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}], "standard_charges": [{"minimum": 35.2, "maximum": 86.56, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 36.82, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 86.56, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 35.92, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 37.0, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 35.92, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 35.2, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 37.72, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 71.84, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 36.64, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 35.92, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 36.64, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D CEPHAL RADIO IMAGE", "code_information": [{"code": "D0702", "type": "HCPCS"}], "standard_charges": [{"minimum": 85.41, "maximum": 210.02, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 89.33, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 210.02, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 89.76, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 85.41, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 91.51, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 174.3, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 88.89, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 88.89, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D CEPHALOMETRIC IMAGE", "code_information": [{"code": "D0340", "type": "HCPCS"}], "standard_charges": [{"minimum": 85.41, "maximum": 210.02, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 89.33, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 210.02, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 89.76, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 85.41, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 91.51, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 174.3, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 88.89, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 88.89, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D ORAL/FACIAL PHOTO IMAGE", "code_information": [{"code": "D0703", "type": "HCPCS"}], "standard_charges": [{"minimum": 85.41, "maximum": 210.02, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 89.33, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 210.02, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 89.76, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 85.41, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 91.51, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 174.3, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 88.89, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 87.15, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 88.89, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TEE W OR W/O FOL W/CON,IN", "code_information": [{"code": "C8925", "type": "HCPCS"}], "standard_charges": [{"minimum": 769.39, "maximum": 1891.87, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 804.72, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 1891.87, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 785.09, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 808.64, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 785.09, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 769.39, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 824.34, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1570.18, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 800.79, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 785.09, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 800.79, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TEE W OR W/O FOL W/CON,IN", "code_information": [{"code": "C8925", "type": "HCPCS"}, {"code": "480", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TEE W OR W/O FOL W/CON,IN", "code_information": [{"code": "C8925", "type": "HCPCS"}, {"code": "481", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TEE W OR W/O FOL W/CON,IN", "code_information": [{"code": "C8925", "type": "HCPCS"}, {"code": "482", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TEE W OR W/O FOL W/CON,IN", "code_information": [{"code": "C8925", "type": "HCPCS"}, {"code": "483", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TEE W OR W/O FOL W/CON,IN", "code_information": [{"code": "C8925", "type": "HCPCS"}, {"code": "489", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,CO", "code_information": [{"code": "C8923", "type": "HCPCS"}], "standard_charges": [{"minimum": 769.39, "maximum": 1891.87, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 804.72, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 1891.87, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 785.09, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 808.64, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 785.09, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 769.39, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 824.34, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1570.18, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 800.79, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 785.09, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 800.79, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,CO", "code_information": [{"code": "C8923", "type": "HCPCS"}, {"code": "480", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,CO", "code_information": [{"code": "C8923", "type": "HCPCS"}, {"code": "481", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,CO", "code_information": [{"code": "C8923", "type": "HCPCS"}, {"code": "482", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,CO", "code_information": [{"code": "C8923", "type": "HCPCS"}, {"code": "483", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,CO", "code_information": [{"code": "C8923", "type": "HCPCS"}, {"code": "489", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,FU", "code_information": [{"code": "C8924", "type": "HCPCS"}], "standard_charges": [{"minimum": 342.4, "maximum": 841.95, "estimated_discounted_cash": 1830.23, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 358.12, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 841.95, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 349.39, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 420.8, "count": "1 through 10", "median_amount": 420.8, "methodology": "percent of total billed charges", "10th_percentile": 420.8, "90th_percentile": 420.8}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 359.87, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 349.39, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 342.4, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 366.86, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 698.78, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 356.38, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 349.39, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 441.58, "count": "1 through 10", "median_amount": 441.58, "methodology": "percent of total billed charges", "10th_percentile": 441.58, "90th_percentile": 441.58}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 356.38, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,FU", "code_information": [{"code": "C8924", "type": "HCPCS"}, {"code": "480", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1830.23, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,FU", "code_information": [{"code": "C8924", "type": "HCPCS"}, {"code": "481", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1830.23, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,FU", "code_information": [{"code": "C8924", "type": "HCPCS"}, {"code": "482", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1830.23, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,FU", "code_information": [{"code": "C8924", "type": "HCPCS"}, {"code": "483", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1830.23, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,FU", "code_information": [{"code": "C8924", "type": "HCPCS"}, {"code": "489", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1830.23, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "250", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "251", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "252", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "253", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "254", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "255", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "256", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "257", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "258", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}, {"code": "259", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3 CC STERILE SYRINGE&NEEDLE", "code_information": [{"code": "A4208", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3 COMP FOOT EXAM COMPLETED", "code_information": [{"code": "G9226", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3-D RADIOTHERAPY PLAN", "code_information": [{"code": "77295", "type": "CPT"}], "standard_charges": [{"minimum": 1358.48, "maximum": 3340.4, "estimated_discounted_cash": 7744.49, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 1420.86, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 3340.4, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1386.2, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 1985.89, "count": "1 through 10", "median_amount": 1985.89, "methodology": "percent of total billed charges", "10th_percentile": 1985.89, "90th_percentile": 1985.89}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 1427.79, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1386.2, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1358.48, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 1455.51, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 2772.4, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1413.92, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1386.2, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_percentage": 58.9, "possible_amount": 4736.04, "count": "1 through 10", "median_amount": 4736.04, "methodology": "percent of total billed charges", "10th_percentile": 4736.04, "90th_percentile": 4736.04}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1413.92, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 1875.56, "count": "1 through 10", "median_amount": 1875.56, "methodology": "percent of total billed charges", "10th_percentile": 1875.56, "90th_percentile": 1875.56}], "billing_class": "facility"}]}, {"description": "3-D RADIOTHERAPY PLAN", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "330", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 7744.49, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 3604.69, "count": "1 through 10", "median_amount": 4303.18, "methodology": "percent of total billed charges", "10th_percentile": 2029.8, "90th_percentile": 4481.08}], "billing_class": "facility"}]}, {"description": "3-D RADIOTHERAPY PLAN", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "331", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 7744.49, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 3604.69, "count": "1 through 10", "median_amount": 4303.18, "methodology": "percent of total billed charges", "10th_percentile": 2029.8, "90th_percentile": 4481.08}], "billing_class": "facility"}]}, {"description": "3-D RADIOTHERAPY PLAN", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "332", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 7744.49, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 3604.69, "count": "1 through 10", "median_amount": 4303.18, "methodology": "percent of total billed charges", "10th_percentile": 2029.8, "90th_percentile": 4481.08}], "billing_class": "facility"}]}, {"description": "3-D RADIOTHERAPY PLAN", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "333", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 7744.49, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 3604.69, "count": "1 through 10", "median_amount": 4303.18, "methodology": "percent of total billed charges", "10th_percentile": 2029.8, "90th_percentile": 4481.08}], "billing_class": "facility"}]}, {"description": "3-D RADIOTHERAPY PLAN", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "335", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 7744.49, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 3604.69, "count": "1 through 10", "median_amount": 4303.18, "methodology": "percent of total billed charges", "10th_percentile": 2029.8, "90th_percentile": 4481.08}], "billing_class": "facility"}]}, {"description": "3-D RADIOTHERAPY PLAN", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "339", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 7744.49, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.1, "possible_amount": 3487.19, "count": "1 through 10", "median_amount": 3487.19, "methodology": "percent of total billed charges", "10th_percentile": 3487.19, "90th_percentile": 3487.19}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 3604.69, "count": "1 through 10", "median_amount": 4303.18, "methodology": "percent of total billed charges", "10th_percentile": 2029.8, "90th_percentile": 4481.08}], "billing_class": "facility"}]}, {"description": "3D DENTAL SCAN DIRECT", "code_information": [{"code": "D0801", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D DENTAL SCAN INDIRECT", "code_information": [{"code": "D0802", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D ECHO IMG CGEN CAR ANOMAL", "code_information": [{"code": "93319", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D ECHO IMG CGEN CAR ANOMAL", "code_information": [{"code": "93319", "type": "CPT"}, {"code": "480", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D ECHO IMG CGEN CAR ANOMAL", "code_information": [{"code": "93319", "type": "CPT"}, {"code": "481", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D ECHO IMG CGEN CAR ANOMAL", "code_information": [{"code": "93319", "type": "CPT"}, {"code": "482", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D ECHO IMG CGEN CAR ANOMAL", "code_information": [{"code": "93319", "type": "CPT"}, {"code": "483", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D ECHO IMG CGEN CAR ANOMAL", "code_information": [{"code": "93319", "type": "CPT"}, {"code": "489", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D FACIAL SCAN DIRECT", "code_information": [{"code": "D0803", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D FACIAL SCAN INDIRECT", "code_information": [{"code": "D0804", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D PRINT OF 3D SURFACE SCAN", "code_information": [{"code": "D0396", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76376", "type": "CPT"}], "standard_charges": [{"minimum": 63.17, "maximum": 2812.0, "estimated_discounted_cash": 445.5, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "Per Code Unique Per Date | Service/Procedure/Item is paid as: Other.", "standard_charge_dollar": 2229.39, "methodology": "other"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 63.17, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 63.17, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 73.35, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 63.17, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 63.17, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 71.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 63.17, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 71.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 73.35, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 73.35, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 71.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 63.17, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 71.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 73.35, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 73.35, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 73.35, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 2812.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 95.48, "count": "1 through 10", "median_amount": 95.48, "methodology": "percent of total billed charges", "10th_percentile": 95.48, "90th_percentile": 95.48}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "350", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 445.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "351", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 445.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "352", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 445.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "359", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 445.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76377", "type": "CPT"}], "standard_charges": [{"minimum": 83.15, "maximum": 2812.0, "estimated_discounted_cash": 1128.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "Per Code Unique Per Date | Service/Procedure/Item is paid as: Other.", "standard_charge_dollar": 2229.39, "methodology": "other"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 242.95, "count": "1 through 10", "median_amount": 242.95, "methodology": "percent of total billed charges", "10th_percentile": 242.95, "90th_percentile": 242.95}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 83.15, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 83.15, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 96.57, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 83.15, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 83.15, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 93.88, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 83.15, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 93.88, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 96.57, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 96.57, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 93.88, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 83.15, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 93.88, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 96.57, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 96.57, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 96.57, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 285.83, "count": "1 through 10", "median_amount": 285.83, "methodology": "percent of total billed charges", "10th_percentile": 285.83, "90th_percentile": 285.83}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 2812.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 269.95, "count": "1 through 10", "median_amount": 269.95, "methodology": "percent of total billed charges", "10th_percentile": 269.95, "90th_percentile": 269.95}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 269.95, "count": "1 through 10", "median_amount": 269.95, "methodology": "percent of total billed charges", "10th_percentile": 269.95, "90th_percentile": 269.95}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "350", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1128.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 644.96, "count": "1 through 10", "median_amount": 644.96, "methodology": "percent of total billed charges", "10th_percentile": 644.96, "90th_percentile": 644.96}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "351", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1128.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 644.96, "count": "1 through 10", "median_amount": 644.96, "methodology": "percent of total billed charges", "10th_percentile": 644.96, "90th_percentile": 644.96}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "352", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1128.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 644.96, "count": "1 through 10", "median_amount": 644.96, "methodology": "percent of total billed charges", "10th_percentile": 644.96, "90th_percentile": 644.96}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "359", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1128.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 644.96, "count": "1 through 10", "median_amount": 644.96, "methodology": "percent of total billed charges", "10th_percentile": 644.96, "90th_percentile": 644.96}], "billing_class": "facility"}]}, {"description": "3D VOL IMG&RCNSTJ BRST/AX", "code_information": [{"code": "694T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation", "code_information": [{"code": "944T", "type": "CPT"}], "standard_charges": [{"minimum": 234.18, "maximum": 575.82, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 244.93, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 575.82, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 238.96, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 246.13, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 238.96, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 234.18, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 250.91, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 477.92, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 243.74, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 238.96, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 243.74, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy", "code_information": [{"code": "G0566", "type": "HCPCS"}], "standard_charges": [{"minimum": 126.29, "maximum": 310.52, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 132.09, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 310.52, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 132.74, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 126.29, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 135.31, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 257.74, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 131.45, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 131.45, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy", "code_information": [{"code": "G0566", "type": "HCPCS"}, {"code": "320", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy", "code_information": [{"code": "G0566", "type": "HCPCS"}, {"code": "321", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy", "code_information": [{"code": "G0566", "type": "HCPCS"}, {"code": "322", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy", "code_information": [{"code": "G0566", "type": "HCPCS"}, {"code": "323", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy", "code_information": [{"code": "G0566", "type": "HCPCS"}, {"code": "324", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy", "code_information": [{"code": "G0566", "type": "HCPCS"}, {"code": "329", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D-CRT/IMRT RECEIVED", "code_information": [{"code": "4165F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3d anatomical segmentation imaging for preoperative planning, data preparation and transmission, obtained from previous diagnostic computed tomographic or magnetic resonance examination of the same anatomy", "code_information": [{"code": "C8001", "type": "HCPCS"}], "standard_charges": [{"minimum": 126.29, "maximum": 310.52, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 132.09, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 310.52, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 132.74, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 126.29, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 135.31, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 257.74, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 131.45, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 131.45, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4 EM CORE SESSIONS", "code_information": [{"code": "G9874", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "40-75Y W/TYPE 1/2 W/LDL-C RS", "code_information": [{"code": "G9676", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}], "standard_charges": [{"minimum": 128.26, "maximum": 128.26, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 128.26, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE AND 0.45% SALINE", "code_information": [{"code": "S5010", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}], "standard_charges": [{"minimum": 7.38, "maximum": 7.38, "estimated_discounted_cash": 82.58, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 26.95, "count": "1 through 10", "median_amount": 32.53, "methodology": "percent of total billed charges", "10th_percentile": 15.78, "90th_percentile": 32.53}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 16.24, "count": "1 through 10", "median_amount": 16.24, "methodology": "percent of total billed charges", "10th_percentile": 16.24, "90th_percentile": 16.24}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 7.38, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 82.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 82.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 82.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 82.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 82.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 82.58, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 82.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE WITH POTASSIUM", "code_information": [{"code": "S5012", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}], "standard_charges": [{"minimum": 1.66, "maximum": 1.66, "estimated_discounted_cash": 65.39, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 15.78, "count": "1 through 10", "median_amount": 15.78, "methodology": "percent of total billed charges", "10th_percentile": 15.78, "90th_percentile": 15.78}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 16.09, "count": "1 through 10", "median_amount": 16.24, "methodology": "percent of total billed charges", "10th_percentile": 15.04, "90th_percentile": 16.71}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 57.0, "possible_amount": 25.6, "count": "1 through 10", "median_amount": 25.6, "methodology": "percent of total billed charges", "10th_percentile": 25.6, "90th_percentile": 25.6}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1.66, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 16.27, "count": "1 through 10", "median_amount": 16.27, "methodology": "percent of total billed charges", "10th_percentile": 16.27, "90th_percentile": 16.27}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 15.47, "count": "1 through 10", "median_amount": 15.78, "methodology": "percent of total billed charges", "10th_percentile": 14.2, "90th_percentile": 16.26}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 65.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 65.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 65.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 65.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 65.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 65.39, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 65.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 37.32, "count": "1 through 10", "median_amount": 37.32, "methodology": "percent of total billed charges", "10th_percentile": 37.32, "90th_percentile": 37.32}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}], "standard_charges": [{"minimum": 2.48, "maximum": 2.48, "estimated_discounted_cash": 78.76, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 15.78, "count": "19", "median_amount": 15.78, "methodology": "percent of total billed charges", "10th_percentile": 15.78, "90th_percentile": 15.78}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 16.84, "count": "13", "median_amount": 15.04, "methodology": "percent of total billed charges", "10th_percentile": 15.04, "90th_percentile": 17.22}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 57.0, "possible_amount": 48.51, "count": "35", "median_amount": 37.7, "methodology": "percent of total billed charges", "10th_percentile": 37.7, "90th_percentile": 75.4}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 2.48, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 22.3, "count": "27", "median_amount": 15.78, "methodology": "percent of total billed charges", "10th_percentile": 15.78, "90th_percentile": 31.56}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 15.04, "count": "15", "median_amount": 15.78, "methodology": "percent of total billed charges", "10th_percentile": 14.2, "90th_percentile": 15.78}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 78.76, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 78.76, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 78.76, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 78.76, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 78.76, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 78.76, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 78.76, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 41.35, "count": "19", "median_amount": 36.4, "methodology": "percent of total billed charges", "10th_percentile": 28.54, "90th_percentile": 72.8}], "billing_class": "facility"}]}, {"description": "5% WL MAINTND FROM BSLINE WT", "code_information": [{"code": "G9888", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5%DEXTROSE/0.45%SALINE1000ML", "code_information": [{"code": "S5013", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5+ CC STERILE SYRINGE&NEEDLE", "code_information": [{"code": "A4209", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "7 FLD RTA PHOTO EVC RTNOPTHY", "code_information": [{"code": "2024F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "7 FLD RTA PHOTO W/O RTNOPTHY", "code_information": [{"code": "2025F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9 EM CORE SESSIONS", "code_information": [{"code": "G9875", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9VHPV VACCINE 2/3 DOSE IM", "code_information": [{"code": "90651", "type": "CPT"}], "standard_charges": [{"minimum": 450.16, "maximum": 450.16, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 450.16, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9VHPV VACCINE 2/3 DOSE IM", "code_information": [{"code": "90651", "type": "CPT"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9VHPV VACCINE 2/3 DOSE IM", "code_information": [{"code": "90651", "type": "CPT"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9VHPV VACCINE 2/3 DOSE IM", "code_information": [{"code": "90651", "type": "CPT"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9VHPV VACCINE 2/3 DOSE IM", "code_information": [{"code": "90651", "type": "CPT"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9VHPV VACCINE 2/3 DOSE IM", "code_information": [{"code": "90651", "type": "CPT"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9VHPV VACCINE 2/3 DOSE IM", "code_information": [{"code": "90651", "type": "CPT"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9VHPV VACCINE 2/3 DOSE IM", "code_information": [{"code": "90651", "type": "CPT"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "<50% TOTAL PT OUTPT RA ENCTS", "code_information": [{"code": "M1008", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "<6YR NEW ONSET HD ACHE", "code_information": [{"code": "G2193", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">55 YRS TEMP HD ACHE", "code_information": [{"code": "G2192", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">= 2 SAME HI-RSK MED NOT ORD", "code_information": [{"code": "G9368", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">= 2 SAME HI-RSK MED ORD", "code_information": [{"code": "G9367", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">=2 SAME HI-RSK MED W/O DIAG", "code_information": [{"code": "M1209", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">=2 SAME MEDS TBL4 NOT ORD", "code_information": [{"code": "M1210", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">=50% TOTAL PT OUTPT RA ENCT", "code_information": [{"code": "M1007", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">=86Y NO HX COLO CA/RSN SCOP", "code_information": [{"code": "G9659", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified", "code_information": [{"code": "M1379", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "A/D HALFWAY HOUSE, PER DIEM", "code_information": [{"code": "H2034", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "A/D TX PROGRAM, PER DIEM", "code_information": [{"code": "H2036", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "A/D TX PROGRAM, PER HOUR", "code_information": [{"code": "H2035", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "270", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "271", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "272", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "273", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "274", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "275", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "276", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "277", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "278", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}, {"code": "279", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}], "standard_charges": [{"minimum": 42.38, "maximum": 104.2, "estimated_discounted_cash": 24760.39, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 44.32, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 104.2, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 43.24, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 57.0, "possible_amount": 14114.0, "count": "1 through 10", "median_amount": 14114.0, "methodology": "percent of total billed charges", "10th_percentile": 14114.0, "90th_percentile": 14114.0}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 44.54, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 43.24, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 42.38, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 45.4, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 86.48, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 44.1, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 43.24, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 54.28, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 4307.98, "count": "1 through 10", "median_amount": 4307.98, "methodology": "percent of total billed charges", "10th_percentile": 4307.98, "90th_percentile": 4307.98}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 44.1, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 6461.97, "count": "1 through 10", "median_amount": 6461.97, "methodology": "percent of total billed charges", "10th_percentile": 6461.97, "90th_percentile": 6461.97}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"minimum": 78.08, "maximum": 78.08, "estimated_discounted_cash": 24760.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"minimum": 78.08, "maximum": 78.08, "estimated_discounted_cash": 24760.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"minimum": 78.08, "maximum": 78.08, "estimated_discounted_cash": 24760.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"minimum": 78.08, "maximum": 78.08, "estimated_discounted_cash": 24760.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"minimum": 78.08, "maximum": 78.08, "estimated_discounted_cash": 24760.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"minimum": 78.08, "maximum": 78.08, "estimated_discounted_cash": 24760.39, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"minimum": 78.08, "maximum": 78.08, "estimated_discounted_cash": 24760.39, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 78.08, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}], "standard_charges": [{"minimum": 681.52, "maximum": 681.52, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 681.52, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD IMAG W/US, CT OR MRI", "code_information": [{"code": "G9455", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}], "standard_charges": [{"minimum": 890.17, "maximum": 4951.29, "estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 931.05, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 2188.87, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 908.34, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 935.59, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 908.34, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 890.17, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 953.76, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1816.68, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 926.51, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 908.34, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1728.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 704.0, "count": "1 through 10", "median_amount": 704.0, "methodology": "percent of total billed charges", "10th_percentile": 704.0, "90th_percentile": 704.0}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 926.51, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2622.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}], "standard_charges": [{"minimum": 256.39, "maximum": 4951.29, "estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 931.05, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 2188.87, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 596.15, "count": "1 through 10", "median_amount": 525.01, "methodology": "percent of total billed charges", "10th_percentile": 525.01, "90th_percentile": 676.81}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 256.39, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 256.39, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 297.74, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 256.39, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 256.39, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 289.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 256.39, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 289.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 297.74, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 297.74, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 289.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 256.39, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 289.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 297.74, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 297.74, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 297.74, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 908.34, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 935.59, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 908.34, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 890.17, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 953.76, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1816.68, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 926.51, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 908.34, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1728.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 607.06, "count": "1 through 10", "median_amount": 583.35, "methodology": "percent of total billed charges", "10th_percentile": 561.02, "90th_percentile": 676.81}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 926.51, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 604.04, "count": "1 through 10", "median_amount": 609.13, "methodology": "percent of total billed charges", "10th_percentile": 545.22, "90th_percentile": 657.76}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2708.85, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}], "standard_charges": [{"minimum": 294.0, "maximum": 722.93, "estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 307.5, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 722.93, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 300.0, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 309.0, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 300.0, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 294.0, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 315.0, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 600.0, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 306.0, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 300.0, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 306.0, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 739.73, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}], "standard_charges": [{"minimum": 3706.93, "maximum": 42315.14, "estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 17998.98, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 3706.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 42315.14, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 17559.98, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 18086.78, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 17559.98, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 17208.78, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 18437.98, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 35119.96, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 17911.18, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 17559.98, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 6041.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 17911.18, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5507.5, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}], "standard_charges": [{"minimum": 4951.29, "maximum": 17511.75, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 7448.72, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 17511.75, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 7267.04, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 7485.05, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 7267.04, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 7121.7, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 7630.39, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 14534.08, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 7412.38, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 7267.04, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 7039.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 7412.38, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "93650", "type": "CPT"}], "standard_charges": [{"minimum": 7039.0, "maximum": 18823.28, "estimated_discounted_cash": 12876.1, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 8006.58, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 10404.5, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 18823.28, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 7811.3, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 8045.64, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 7811.3, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 7655.07, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 8201.87, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 15622.6, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 7967.53, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 7811.3, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 7039.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 7967.53, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}], "standard_charges": [{"minimum": 1522.82, "maximum": 3744.52, "estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 1592.75, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 3706.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 3744.52, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1553.9, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 945.78, "count": "1 through 10", "median_amount": 945.78, "methodology": "percent of total billed charges", "10th_percentile": 945.78, "90th_percentile": 945.78}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 1600.52, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1553.9, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1522.82, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 1631.6, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 3107.8, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1584.98, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1553.9, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1728.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1584.98, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4258.17, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}], "standard_charges": [{"minimum": 1522.82, "maximum": 3744.52, "estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 1592.75, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 3706.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 3744.52, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1553.9, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 1600.52, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1553.9, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1522.82, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 1631.6, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 3107.8, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1584.98, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1553.9, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1728.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1584.98, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 11523.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}], "standard_charges": [{"minimum": 7039.0, "maximum": 25653.47, "estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 10911.83, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7185.9, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 25653.47, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 10645.69, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 10965.06, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 10645.69, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 10432.78, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 11177.97, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 21291.38, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 10858.6, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 10645.69, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 7039.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 10858.6, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 693.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}], "standard_charges": [{"minimum": 5933.46, "maximum": 14589.95, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 6205.91, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7185.9, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 14589.95, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 6054.55, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 6236.19, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 6054.55, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 5933.46, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 6357.28, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 12109.1, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 6175.64, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 6054.55, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 7039.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 6175.64, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ B9 THYR NDUL PERQ LASR", "code_information": [{"code": "673T", "type": "CPT"}], "standard_charges": [{"minimum": 1620.98, "maximum": 3985.88, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 1695.41, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 3706.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 3985.88, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1654.06, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 1703.68, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1654.06, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1620.98, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 1736.76, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 3308.12, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1687.14, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1654.06, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1728.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1687.14, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL BRST TUM PERQ CRTX", "code_information": [{"code": "581T", "type": "CPT"}], "standard_charges": [{"minimum": 3842.85, "maximum": 9449.3, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 4019.31, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7185.9, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 9449.3, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 3921.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 4038.92, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 3921.28, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 3842.85, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 4117.34, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 7842.56, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 3999.71, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 3921.28, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3928.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 3999.71, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 MAG FLD NDCT", "code_information": [{"code": "739T", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 4951.29, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}], "standard_charges": [{"minimum": 3928.0, "maximum": 22845.85, "estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 9717.59, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 22845.85, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 9480.58, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 9765.0, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 9480.58, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 9290.97, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 9954.61, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 18961.16, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 9670.19, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 9480.58, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3928.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 9670.19, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9990.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ PERC LXTR/PERPH NRV", "code_information": [{"code": "441T", "type": "CPT"}], "standard_charges": [{"minimum": 1916.53, "maximum": 6041.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 2004.53, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 4712.6, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1955.64, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 2014.31, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1955.64, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1916.53, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 2053.42, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 3911.28, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1994.75, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1955.64, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 6041.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1994.75, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ PERC PLEX/TRNCL NRV", "code_information": [{"code": "442T", "type": "CPT"}], "standard_charges": [{"minimum": 6041.0, "maximum": 21179.16, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 9008.66, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 21179.16, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 8788.94, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 9052.61, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 8788.94, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 8613.16, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 9228.39, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 17577.88, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 8964.72, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 8788.94, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 6041.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 8964.72, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ PERC UXTR/PERPH NRV", "code_information": [{"code": "440T", "type": "CPT"}], "standard_charges": [{"minimum": 1916.53, "maximum": 6041.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 2004.53, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 4712.6, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1955.64, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 2014.31, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1955.64, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1916.53, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 2053.42, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 3911.28, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1994.75, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1955.64, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 6041.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1994.75, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}], "standard_charges": [{"minimum": 269.33, "maximum": 662.27, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 281.7, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 662.27, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 283.07, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 269.33, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 288.57, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 549.66, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 280.33, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 280.33, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}], "standard_charges": [{"minimum": 269.33, "maximum": 662.27, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 281.7, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 662.27, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 283.07, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 269.33, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 288.57, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 549.66, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 280.33, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 280.33, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO RH BLOOD TYPING DOCD", "code_information": [{"code": "3293F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}], "standard_charges": [{"minimum": 8.41, "maximum": 20.68, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 8.79, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 20.68, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 8.58, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 8.84, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 8.58, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 8.41, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 9.01, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 17.16, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 8.75, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 8.58, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 10.09, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 8.75, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"minimum": 16.28, "maximum": 16.28, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"minimum": 16.28, "maximum": 16.28, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"minimum": 16.28, "maximum": 16.28, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"minimum": 16.28, "maximum": 16.28, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"minimum": 16.28, "maximum": 16.28, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"minimum": 16.28, "maximum": 16.28, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"minimum": 16.28, "maximum": 16.28, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 16.28, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}], "standard_charges": [{"minimum": 3177.12, "maximum": 8582.93, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 3323.01, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 8582.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 7812.29, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 3241.96, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 3339.22, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 3241.96, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 3177.12, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 3404.06, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 6483.92, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 3306.8, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 3241.96, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3928.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 3306.8, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}], "standard_charges": [{"minimum": 3177.12, "maximum": 8582.93, "estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 3323.01, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 8582.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 7812.29, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 3241.96, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 3339.22, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 3241.96, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 3177.12, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 3404.06, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 6483.92, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 3306.8, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 3241.96, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3928.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 3306.8, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4215.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 4951.29, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 4951.29, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 4951.29, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}], "standard_charges": [{"minimum": 1728.0, "maximum": 4951.29, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1728.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}], "standard_charges": [{"minimum": 1172.0, "maximum": 4951.29, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}], "standard_charges": [{"minimum": 299.08, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 312.81, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 735.41, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 305.18, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 314.34, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 305.18, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 299.08, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 320.44, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 610.36, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 311.28, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 305.18, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 311.28, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY", "code_information": [{"code": "770", "type": "MS-DRG"}], "standard_charges": [{"minimum": 5724.88, "maximum": 23517.33, "estimated_discounted_cash": 16483.5, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 8989.97, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 15165.84, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 17102.87, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 7978.51, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 12593.91, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 8770.7, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 12593.91, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 16045.21, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 16045.21, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 11029.7, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 7822.07, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 11250.29, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 17459.01, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 9033.82, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 8770.7, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 9209.24, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 7822.07, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 17541.4, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 5724.88, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 8770.7, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 23517.33, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 7978.51, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 8946.11, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 7978.51, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABORTION WITHOUT D&C", "code_information": [{"code": "779", "type": "MS-DRG"}], "standard_charges": [{"minimum": 4803.37, "maximum": 19731.85, "estimated_discounted_cash": 16420.23, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 7542.89, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 12724.66, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 14349.89, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 5969.29, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 10566.73, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 7358.92, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 10566.73, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 13462.48, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 13462.48, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 9254.3, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 5852.24, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 9439.39, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 14648.72, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 7579.69, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 7358.92, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 7726.87, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 5852.24, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 14717.84, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 4803.37, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 7358.92, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 19731.85, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 5969.29, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 7506.1, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 5969.29, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ABOVE KNEE SURGICAL STOCKING", "code_information": [{"code": "A4490", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}], "standard_charges": [{"minimum": 196.91, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 205.95, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 484.2, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 200.93, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 206.96, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 200.93, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 196.91, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 210.98, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 401.86, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 204.95, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 200.93, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 204.95, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}], "standard_charges": [{"minimum": 361.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSCESS DRAINAGE UNDER X-RAY", "code_information": [{"code": "75989", "type": "CPT"}], "standard_charges": [{"minimum": 117.55, "maximum": 136.51, "estimated_discounted_cash": 1186.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 117.55, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 117.55, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 136.51, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 117.55, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 117.55, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 132.72, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 117.55, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 132.72, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 136.51, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 136.51, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 132.72, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 117.55, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 132.72, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 136.51, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 136.51, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 136.51, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 274.36, "count": "1 through 10", "median_amount": 274.36, "methodology": "percent of total billed charges", "10th_percentile": 274.36, "90th_percentile": 274.36}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 259.12, "count": "1 through 10", "median_amount": 259.12, "methodology": "percent of total billed charges", "10th_percentile": 259.12, "90th_percentile": 259.12}], "billing_class": "facility"}]}, {"description": "ABSCESS DRAINAGE UNDER X-RAY", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "320", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1186.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSCESS DRAINAGE UNDER X-RAY", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "321", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1186.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSCESS DRAINAGE UNDER X-RAY", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "322", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1186.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSCESS DRAINAGE UNDER X-RAY", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "323", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1186.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSCESS DRAINAGE UNDER X-RAY", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "324", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1186.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSCESS DRAINAGE UNDER X-RAY", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "329", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1186.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 48.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "270", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "271", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "272", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "273", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "274", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "275", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "276", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "277", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "278", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}, {"code": "279", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "270", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "271", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "272", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "273", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "274", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "275", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "276", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "277", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "278", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}, {"code": "279", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "270", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "271", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "272", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "273", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "274", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "275", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "276", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "277", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "278", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}, {"code": "279", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORPT DRG > 48 SQ IN W/BDR", "code_information": [{"code": "A6256", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUT CROWN PORC TO TITANIUM", "code_information": [{"code": "D6097", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUT RETAIN PORC TO TITANIUM", "code_information": [{"code": "D6195", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUT SUPPORT CROWN TITANIUM", "code_information": [{"code": "D6094", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUT SUPPORT RETAINER TITANI", "code_information": [{"code": "D6194", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED CROWN", "code_information": [{"code": "D6058", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6059", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6060", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6061", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6062", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6063", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6064", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6068", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6069", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6070", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6071", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6072", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6073", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6074", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABX PRES W/IN 10 DYS OF SYMP", "code_information": [{"code": "G9505", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABX REG PRESCRIBED", "code_information": [{"code": "G9498", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}], "standard_charges": [{"minimum": 122.14, "maximum": 2495.95, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 127.75, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 300.33, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 128.37, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 122.14, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 130.86, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 249.26, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 2495.95, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS OF TRANSEP CYTOL SAMP", "code_information": [{"code": "D0486", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}], "standard_charges": [{"minimum": 361.0, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS/RETORQ IMPLANT SCREW", "code_information": [{"code": "D6089", "type": "HCPCS"}], "standard_charges": [{"minimum": 1172.0, "maximum": 1172.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1172.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE ARB ARNI", "code_information": [{"code": "G2092", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE-I/ARB RX", "code_information": [{"code": "M1200", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB NOT RX'D; DOC REAS", "code_information": [{"code": "G8474", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB THERAPY RXD/TAKEN", "code_information": [{"code": "4010F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB THXPY FOR MOS/>", "code_information": [{"code": "4210F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB THXPY NOT RX'D", "code_information": [{"code": "G8475", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB THXPY RX'D", "code_information": [{"code": "G8473", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}], "standard_charges": [{"minimum": 361.0, "maximum": 3706.93, "estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 3706.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 1292.24, "count": "1 through 10", "median_amount": 1292.24, "methodology": "percent of total billed charges", "10th_percentile": 1292.24, "90th_percentile": 1292.24}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 1440.21, "count": "1 through 10", "median_amount": 1426.28, "methodology": "percent of total billed charges", "10th_percentile": 1426.28, "90th_percentile": 1454.13}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 2259.3, "count": "1 through 10", "median_amount": 2348.02, "methodology": "percent of total billed charges", "10th_percentile": 1515.03, "90th_percentile": 2914.86}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 5531.9, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}], "standard_charges": [{"minimum": 122.14, "maximum": 1933.33, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 127.75, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 300.33, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 128.37, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 122.14, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 130.86, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 249.26, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 1933.33, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}], "standard_charges": [{"minimum": 122.14, "maximum": 2579.93, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 127.75, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 300.33, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 128.37, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 122.14, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 130.86, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 249.26, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 2579.93, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETATE CONC SOL PER GALLON", "code_information": [{"code": "A4708", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}], "standard_charges": [{"minimum": 21.02, "maximum": 21.02, "estimated_discounted_cash": 412.3, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 21.02, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 412.3, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 412.3, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 412.3, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 412.3, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 412.3, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 412.3, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 412.3, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 229.65, "count": "1 through 10", "median_amount": 229.65, "methodology": "percent of total billed charges", "10th_percentile": 229.65, "90th_percentile": 229.65}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}], "standard_charges": [{"minimum": 8.01, "maximum": 19.69, "estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 8.37, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 19.69, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 15.2, "count": "1 through 10", "median_amount": 15.2, "methodology": "percent of total billed charges", "10th_percentile": 15.2, "90th_percentile": 15.2}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 8.17, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 14.48, "count": "1 through 10", "median_amount": 14.48, "methodology": "percent of total billed charges", "10th_percentile": 14.48, "90th_percentile": 14.48}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 8.42, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 8.17, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 8.01, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 8.58, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 16.34, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 8.33, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 8.17, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 15.2, "count": "1 through 10", "median_amount": 15.2, "methodology": "percent of total billed charges", "10th_percentile": 15.2, "90th_percentile": 15.2}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 8.33, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 14.95, "count": "1 through 10", "median_amount": 15.2, "methodology": "percent of total billed charges", "10th_percentile": 13.68, "90th_percentile": 15.2}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 145.89, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 84.1, "count": "1 through 10", "median_amount": 84.1, "methodology": "percent of total billed charges", "10th_percentile": 84.1, "90th_percentile": 84.1}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}], "standard_charges": [{"minimum": 12.04, "maximum": 29.61, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 12.6, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 29.61, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 12.29, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 12.66, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 12.29, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 12.04, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 12.9, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 24.58, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 12.54, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 12.29, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 12.54, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}], "standard_charges": [{"minimum": 18.03, "maximum": 44.35, "estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 18.86, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 44.35, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 18.4, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 18.95, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 18.4, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 18.03, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 19.32, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 36.8, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 18.77, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 18.4, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_percentage": 58.9, "possible_amount": 143.44, "count": "1 through 10", "median_amount": 143.44, "methodology": "percent of total billed charges", "10th_percentile": 143.44, "90th_percentile": 143.44}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 18.77, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.75, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}], "standard_charges": [{"minimum": 18.03, "maximum": 44.35, "estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 18.86, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 44.35, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 18.4, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 18.95, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 18.4, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 18.03, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 19.32, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 36.8, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 18.77, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 18.4, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_percentage": 58.9, "possible_amount": 143.44, "count": "1 through 10", "median_amount": 143.44, "methodology": "percent of total billed charges", "10th_percentile": 143.44, "90th_percentile": 143.44}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 18.77, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 234.82, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}], "standard_charges": [{"minimum": 11.81, "maximum": 29.05, "estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 12.35, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 29.05, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 12.05, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 12.41, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 12.05, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 11.81, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 12.65, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 24.1, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 12.29, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 12.05, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_percentage": 58.9, "possible_amount": 145.89, "count": "1 through 10", "median_amount": 145.89, "methodology": "percent of total billed charges", "10th_percentile": 145.89, "90th_percentile": 145.89}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 12.29, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 238.91, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "250", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "251", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "252", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "253", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "254", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "255", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "256", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "257", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "258", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}, {"code": "259", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}], "standard_charges": [{"minimum": 0.45, "maximum": 0.45, "estimated_discounted_cash": 2294.15, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 0.45, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2294.15, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2294.15, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2294.15, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2294.15, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2294.15, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2294.15, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 2294.15, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}], "standard_charges": [{"minimum": 10.85, "maximum": 10.85, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 10.85, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACID CONC SOL PER GALLON", "code_information": [{"code": "A4709", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACID PERFUSION OF ESOPHAGUS", "code_information": [{"code": "91030", "type": "CPT"}], "standard_charges": [{"minimum": 361.0, "maximum": 900.56, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 383.05, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 900.56, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 373.71, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 384.92, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 373.71, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 366.24, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 392.4, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 747.42, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 381.18, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 373.71, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 381.18, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}], "standard_charges": [{"minimum": 196.91, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 205.95, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 484.2, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 200.93, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 206.96, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 200.93, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 196.91, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 210.98, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 401.86, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 204.95, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 200.93, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 204.95, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC IMMITANCE TESTING", "code_information": [{"code": "92570", "type": "CPT"}], "standard_charges": [{"minimum": 126.29, "maximum": 310.52, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 132.09, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 310.52, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 132.74, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 126.29, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 135.31, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 257.74, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 131.45, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 128.87, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 131.45, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC IMMITANCE TESTING", "code_information": [{"code": "92570", "type": "CPT"}, {"code": "470", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC IMMITANCE TESTING", "code_information": [{"code": "92570", "type": "CPT"}, {"code": "471", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC IMMITANCE TESTING", "code_information": [{"code": "92570", "type": "CPT"}, {"code": "472", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC IMMITANCE TESTING", "code_information": [{"code": "92570", "type": "CPT"}, {"code": "479", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC REFL THRESHOLD TST", "code_information": [{"code": "92568", "type": "CPT"}], "standard_charges": [{"minimum": 36.66, "maximum": 90.14, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 38.35, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 90.14, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 37.41, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 38.53, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 37.41, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 36.66, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 39.28, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 74.82, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 38.16, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 37.41, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 38.16, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC REFL THRESHOLD TST", "code_information": [{"code": "92568", "type": "CPT"}, {"code": "470", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC REFL THRESHOLD TST", "code_information": [{"code": "92568", "type": "CPT"}, {"code": "471", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC REFL THRESHOLD TST", "code_information": [{"code": "92568", "type": "CPT"}, {"code": "472", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC REFL THRESHOLD TST", "code_information": [{"code": "92568", "type": "CPT"}, {"code": "479", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACP DISCUSS-NO DSCNMKR DOCD", "code_information": [{"code": "1124F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACP DISCUSS/DSCN MKR DOCD", "code_information": [{"code": "1123F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}], "standard_charges": [{"minimum": 31.97, "maximum": 78.62, "estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 33.44, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 78.62, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 32.62, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 33.6, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 32.62, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 31.97, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 34.25, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 65.24, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 33.27, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 32.62, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 33.27, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 270.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}], "standard_charges": [{"minimum": 85.22, "maximum": 209.54, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 89.13, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 209.54, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 86.96, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 89.57, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 86.96, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 85.22, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 91.31, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 173.92, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 88.7, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 86.96, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 88.7, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}], "standard_charges": [{"minimum": 76.69, "maximum": 188.6, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 80.22, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 188.6, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 78.26, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 80.61, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 78.26, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 76.69, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 82.17, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 156.52, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 79.83, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 78.26, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 79.83, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIGRAPHY TESTING", "code_information": [{"code": "95803", "type": "CPT"}], "standard_charges": [{"minimum": 57.9, "maximum": 142.38, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 60.56, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 142.38, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 102.98, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 102.98, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 119.59, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 102.98, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 102.98, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 116.27, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 102.98, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 116.27, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 119.59, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 119.59, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 116.27, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 102.98, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 116.27, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 119.59, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 119.59, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 119.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 59.08, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 60.85, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 59.08, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 57.9, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 62.03, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 118.16, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 60.26, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 59.08, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 60.26, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}], "standard_charges": [{"minimum": 11.81, "maximum": 29.05, "estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 12.35, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 29.05, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 12.05, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 1.03, "count": "1 through 10", "median_amount": 1.03, "methodology": "percent of total billed charges", "10th_percentile": 1.03, "90th_percentile": 1.03}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 12.41, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 12.05, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 11.81, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 12.65, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 24.1, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 12.29, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 12.05, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 0.97, "count": "1 through 10", "median_amount": 0.97, "methodology": "percent of total billed charges", "10th_percentile": 0.97, "90th_percentile": 0.97}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 12.29, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 4.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 2.32, "count": "1 through 10", "median_amount": 2.32, "methodology": "percent of total billed charges", "10th_percentile": 2.32, "90th_percentile": 2.32}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}], "standard_charges": [{"minimum": 122.14, "maximum": 2203.73, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 127.75, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 300.33, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 128.37, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 122.14, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 130.86, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 249.26, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 2203.73, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATED CARBON FILTER, EA", "code_information": [{"code": "A4680", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVITY THERAPY, PER 15 MIN", "code_information": [{"code": "H2032", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUPUNCT W/O STIMUL 15 MIN", "code_information": [{"code": "97810", "type": "CPT"}], "standard_charges": [{"minimum": 28.39, "maximum": 69.8, "estimated_discounted_cash": 1225.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 29.69, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 69.8, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 28.97, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 29.84, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 28.97, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 28.39, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 30.42, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 57.94, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 29.55, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 28.97, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 29.55, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUPUNCT W/O STIMUL ADDL 15M", "code_information": [{"code": "97811", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUPUNCT W/STIMUL 15 MIN", "code_information": [{"code": "97813", "type": "CPT"}], "standard_charges": [{"minimum": 28.39, "maximum": 69.8, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 29.69, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 69.8, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 28.97, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 29.84, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 28.97, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 28.39, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 30.42, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 57.94, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 29.55, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 28.97, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 29.55, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUPUNCT W/STIMUL ADDL 15M", "code_information": [{"code": "97814", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION", "code_information": [{"code": "880", "type": "MS-DRG"}], "standard_charges": [{"minimum": 1285.0, "maximum": 22520.53, "estimated_discounted_cash": 25928.85, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 8608.92, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 14523.03, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 16377.95, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.56, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 1285.0, "methodology": "per diem"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 8398.95, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 1285.0, "methodology": "per diem"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 1638.0, "methodology": "per diem"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 1638.0, "methodology": "per diem"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 10562.2, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 10773.44, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 16719.0, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 8650.92, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 8398.95, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 8818.9, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 16797.9, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 5482.22, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 8398.95, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 22520.53, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.56, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 8566.93, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 33.56, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE AND SUBACUTE ENDOCARDITIS WITH CC", "code_information": [{"code": "289", "type": "MS-DRG"}], "standard_charges": [{"minimum": 9745.48, "maximum": 40033.63, "estimated_discounted_cash": 45726.74, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 15303.65, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 25816.86, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 29114.26, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 22068.86, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 21438.66, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 14930.39, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 21438.66, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 27313.81, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 27313.81, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 18775.9, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 21636.14, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 19151.42, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 29720.54, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 15378.3, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 14930.39, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 15676.91, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 21636.14, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 29860.78, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 9745.48, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 14930.39, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 40033.63, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 22068.86, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 15229.0, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 22068.86, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC", "code_information": [{"code": "288", "type": "MS-DRG"}], "standard_charges": [{"minimum": 15450.94, "maximum": 63471.21, "estimated_discounted_cash": 98739.57, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 24263.13, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 40931.28, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 46159.13, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 39453.37, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 33989.87, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 23671.35, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 33989.87, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 43304.61, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 43304.61, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 29768.2, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 38679.78, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 30363.56, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 47120.35, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 24381.49, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 23671.35, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 24854.92, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 38679.78, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 47342.7, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 15450.94, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 23671.35, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 63471.21, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 39453.37, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 24144.78, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 39453.37, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC", "code_information": [{"code": "290", "type": "MS-DRG"}], "standard_charges": [{"minimum": 5308.08, "maximum": 21805.18, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 8335.46, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 14061.71, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 15857.71, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 15587.7, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 11677.03, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 8132.16, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 11677.03, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 14877.06, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 14877.06, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 10226.7, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 15282.06, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 10431.23, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 16187.94, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 8376.12, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 8132.16, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 8538.77, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 15282.06, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 16264.32, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 5308.08, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 8132.16, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 21805.18, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 15587.7, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 8294.8, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 15587.7, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE CHRONIC OBSTRUCT", "code_information": [{"code": "G9681", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE CONGESTIVE HEART", "code_information": [{"code": "G9680", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE PNEUMONIA", "code_information": [{"code": "G9679", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE SKIN INFECTION", "code_information": [{"code": "G9682", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE URINARY TRACT INF", "code_information": [{"code": "G9684", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE FLUID/ELECTRO DISORDER", "code_information": [{"code": "G9683", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMAGING", "code_information": [{"code": "78278", "type": "CPT"}], "standard_charges": [{"minimum": 277.23, "maximum": 964.78, "estimated_discounted_cash": 1826.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 410.38, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 964.78, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 277.23, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 277.23, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 321.95, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 277.23, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 277.23, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 313.01, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 277.23, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 313.01, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 321.95, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 321.95, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 313.01, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 277.23, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 313.01, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 321.95, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 321.95, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 321.95, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 400.37, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 412.38, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 400.37, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 392.36, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 420.39, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 800.74, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 408.38, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 400.37, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 408.38, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMAGING", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "340", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1826.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMAGING", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "341", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1826.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMAGING", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "342", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1826.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMAGING", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "343", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1826.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMAGING", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "344", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1826.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMAGING", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "349", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 1826.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}], "standard_charges": [{"minimum": 46.68, "maximum": 114.77, "estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 48.82, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 114.77, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 85.46, "count": "1 through 10", "median_amount": 86.7, "methodology": "percent of total billed charges", "10th_percentile": 78.03, "90th_percentile": 86.7}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 47.63, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 92.68, "count": "1 through 10", "median_amount": 91.8, "methodology": "percent of total billed charges", "10th_percentile": 82.62, "90th_percentile": 107.17}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 49.06, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 47.63, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 46.68, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 50.01, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 95.26, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 48.58, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 47.63, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_percentage": 58.9, "possible_amount": 233.38, "count": "1 through 10", "median_amount": 275.48, "methodology": "percent of total billed charges", "10th_percentile": 78.03, "90th_percentile": 369.9}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 86.7, "count": "13", "median_amount": 86.7, "methodology": "percent of total billed charges", "10th_percentile": 86.7, "90th_percentile": 86.7}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 48.58, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 83.6, "count": "14", "median_amount": 86.7, "methodology": "percent of total billed charges", "10th_percentile": 78.03, "90th_percentile": 86.7}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 52.9, "possible_amount": 263.13, "count": "1 through 10", "median_amount": 263.13, "methodology": "percent of total billed charges", "10th_percentile": 263.13, "90th_percentile": 263.13}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 608.71, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 350.32, "count": "1 through 10", "median_amount": 350.32, "methodology": "percent of total billed charges", "10th_percentile": 350.32, "90th_percentile": 350.32}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITH CC", "code_information": [{"code": "835", "type": "MS-DRG"}], "standard_charges": [{"minimum": 11908.79, "maximum": 48920.35, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 18700.78, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 31547.73, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 35577.09, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 38559.74, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 26197.65, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 18244.66, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 26197.65, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 33376.97, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 33376.97, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 22943.8, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 37803.68, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 23402.68, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 36317.95, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 18792.0, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 18244.66, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 19156.89, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 37803.68, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 36489.32, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 11908.79, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 18244.66, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 48920.35, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 38559.74, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 18609.55, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 38559.74, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITH MCC", "code_information": [{"code": "834", "type": "MS-DRG"}], "standard_charges": [{"minimum": 31344.36, "maximum": 128760.11, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 49221.1, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 83034.74, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 93640.15, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 103440.23, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 68953.14, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 48020.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 68953.14, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 87849.38, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 87849.38, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 60388.9, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 101412.01, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 61596.68, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 95590.14, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 49461.21, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 48020.59, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 50421.62, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 101412.01, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 96041.18, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 31344.36, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 48020.59, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 128760.11, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 103440.23, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 48981.0, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 103440.23, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITH OTHER PROCEDURES", "code_information": [{"code": "850", "type": "MS-DRG"}], "standard_charges": [{"minimum": 49441.07, "maximum": 203099.91, "estimated_discounted_cash": 212266.34, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 77638.97, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 130974.94, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 147703.41, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 64236.58, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 108763.32, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 75745.34, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 108763.32, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 138569.32, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 138569.32, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 95254.5, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 62977.05, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 97159.59, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 150779.21, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 78017.7, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 75745.34, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 79532.61, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 62977.05, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 151490.68, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 49441.07, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 75745.34, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 203099.91, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 64236.58, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 77260.25, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 64236.58, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITHOUT CC/MCC", "code_information": [{"code": "836", "type": "MS-DRG"}], "standard_charges": [{"minimum": 6962.69, "maximum": 28602.15, "estimated_discounted_cash": 131730.2, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 10933.74, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 18444.94, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 20800.77, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 20444.26, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 15316.92, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 10667.06, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 15316.92, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 19514.44, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 19514.44, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 13414.5, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 20043.4, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 13682.79, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 21233.93, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 10987.07, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 10667.06, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 11200.41, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 20043.4, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 21334.12, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 6962.69, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 10667.06, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 28602.15, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 20444.26, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 10880.4, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 20444.26, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE MAJOR EYE INFECTIONS WITH CC/MCC", "code_information": [{"code": "121", "type": "MS-DRG"}], "standard_charges": [{"minimum": 6641.81, "maximum": 27284.04, "estimated_discounted_cash": 32443.19, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 10429.87, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 17594.91, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 19842.19, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 8739.14, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 14611.05, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 10175.48, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 14611.05, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 18615.13, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 18615.13, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 12796.3, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 8567.78, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 13052.23, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 20255.38, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 10480.74, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 10175.48, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 10684.25, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 8567.78, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 20350.96, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 6641.81, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 10175.48, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 27284.04, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 8739.14, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 10378.99, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 8739.14, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC", "code_information": [{"code": "122", "type": "MS-DRG"}], "standard_charges": [{"minimum": 4486.49, "maximum": 18430.15, "estimated_discounted_cash": 13152.25, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 7045.3, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 11885.23, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 13403.25, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 5511.95, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 9869.65, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 6873.46, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 9869.65, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 12574.37, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 12574.37, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 8643.8, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 5403.88, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 8816.68, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 13682.35, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 7079.66, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 6873.46, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 7217.13, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 5403.88, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 13746.92, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 4486.49, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 6873.46, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 18430.15, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 5511.95, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 7010.93, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 5511.95, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC", "code_information": [{"code": "281", "type": "MS-DRG"}], "standard_charges": [{"minimum": 5247.56, "maximum": 21556.57, "estimated_discounted_cash": 36765.31, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 8240.43, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 13901.39, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 15676.91, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 10445.06, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 11543.9, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 8039.44, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 11543.9, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 14707.44, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 14707.44, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 10110.1, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 10240.26, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 10312.3, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 16003.37, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 8280.62, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 8039.44, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 8441.41, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 10240.26, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 16078.88, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 5247.56, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 8039.44, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 21556.57, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 10445.06, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 8200.23, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 10445.06, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC", "code_information": [{"code": "280", "type": "MS-DRG"}], "standard_charges": [{"minimum": 9158.54, "maximum": 37622.56, "estimated_discounted_cash": 48147.64, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 14381.97, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 24262.01, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 27360.82, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 16146.45, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 20147.5, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 14031.19, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 20147.5, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 25668.81, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 25668.81, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 17645.1, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 15829.86, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 17998.0, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 27930.59, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 14452.13, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 14031.19, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 14732.75, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 15829.86, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 28062.38, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 9158.54, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 14031.19, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 37622.56, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 16146.45, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 14311.81, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 16146.45, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC", "code_information": [{"code": "282", "type": "MS-DRG"}], "standard_charges": [{"minimum": 4128.51, "maximum": 16959.59, "estimated_discounted_cash": 33878.38, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 6483.14, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 10936.89, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 12333.77, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 8802.28, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 9082.14, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 6325.01, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 9082.14, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 11571.05, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 11571.05, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 7954.1, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 8629.69, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 8113.18, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 12590.62, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 6514.76, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 6325.01, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 6641.26, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 8629.69, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 12650.02, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 4128.51, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 6325.01, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 16959.59, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 8802.28, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 6451.51, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 8802.28, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC", "code_information": [{"code": "284", "type": "MS-DRG"}], "standard_charges": [{"minimum": 3952.09, "maximum": 16234.86, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 6206.1, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 10469.53, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 11806.72, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 9668.16, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 8694.03, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 6054.73, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 8694.03, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 11076.58, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 11076.58, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 7614.2, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 9478.59, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 7766.48, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 12052.59, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 6236.37, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 6054.73, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 6357.47, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 9478.59, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 12109.46, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 3952.09, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 6054.73, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 16234.86, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 9668.16, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 6175.82, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 9668.16, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC", "code_information": [{"code": "283", "type": "MS-DRG"}], "standard_charges": [{"minimum": 11309.3, "maximum": 46457.68, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 17759.38, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 29959.6, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 33786.13, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 22381.72, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 24878.85, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 17326.22, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 24878.85, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 31696.76, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 31696.76, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 21788.8, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 21942.87, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 22224.58, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 34489.69, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 17846.01, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 17326.22, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 18192.53, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 21942.87, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 34652.44, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 11309.3, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 17326.22, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 46457.68, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 22381.72, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 17672.74, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 22381.72, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC", "code_information": [{"code": "285", "type": "MS-DRG"}], "standard_charges": [{"minimum": 3419.4, "maximum": 14046.6, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 5369.6, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 9058.36, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 10215.33, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 9668.16, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 7522.18, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 5238.63, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 7522.18, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 9583.6, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 9583.6, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 6587.9, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 9478.59, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 6719.66, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 10428.05, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 5395.79, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 5238.63, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 5500.56, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 9478.59, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 10477.26, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 3419.4, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 5238.63, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 14046.6, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 9668.16, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 5343.4, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 9668.16, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ACUTE NURSING FACILITY CARE", "code_information": [{"code": "G9685", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE PVD", "code_information": [{"code": "M1337", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VENOUS THROMBUS IMAGE", "code_information": [{"code": "78456", "type": "CPT"}], "standard_charges": [{"minimum": 285.32, "maximum": 3124.44, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 1328.99, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 3124.44, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 285.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 285.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 331.34, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 285.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 285.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 322.14, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 285.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 322.14, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 331.34, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 331.34, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 322.14, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 285.32, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 322.14, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 331.34, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 331.34, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 331.34, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1296.58, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 1335.48, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1296.58, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1270.65, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 1361.41, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 2593.16, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1322.51, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1296.58, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1322.51, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VENOUS THROMBUS IMAGE", "code_information": [{"code": "78456", "type": "CPT"}, {"code": "340", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VENOUS THROMBUS IMAGE", "code_information": [{"code": "78456", "type": "CPT"}, {"code": "341", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VENOUS THROMBUS IMAGE", "code_information": [{"code": "78456", "type": "CPT"}, {"code": "342", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VENOUS THROMBUS IMAGE", "code_information": [{"code": "78456", "type": "CPT"}, {"code": "343", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VENOUS THROMBUS IMAGE", "code_information": [{"code": "78456", "type": "CPT"}, {"code": "344", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VENOUS THROMBUS IMAGE", "code_information": [{"code": "78456", "type": "CPT"}, {"code": "349", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VITREOUS HEMORRHAGE", "code_information": [{"code": "M1333", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}], "standard_charges": [{"minimum": 0.04, "maximum": 0.04, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 0.04, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}], "standard_charges": [{"minimum": 16.16, "maximum": 39.74, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 16.9, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 39.74, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 16.49, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 16.98, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 16.49, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 16.16, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 17.31, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 32.98, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 16.82, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 16.49, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 16.82, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}], "standard_charges": [{"minimum": 16.53, "maximum": 40.66, "estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 17.29, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 40.66, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 16.87, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 33.23, "count": "1 through 10", "median_amount": 33.23, "methodology": "percent of total billed charges", "10th_percentile": 33.23, "90th_percentile": 33.23}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 17.38, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 16.87, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 16.53, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 17.71, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 33.74, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 17.21, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 16.87, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_percentage": 58.9, "possible_amount": 132.56, "count": "1 through 10", "median_amount": 132.56, "methodology": "percent of total billed charges", "10th_percentile": 132.56, "90th_percentile": 132.56}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 17.21, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 218.6, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 56.9, "possible_amount": 127.46, "count": "1 through 10", "median_amount": 127.46, "methodology": "percent of total billed charges", "10th_percentile": 127.46, "90th_percentile": 127.46}], "billing_class": "facility"}]}, {"description": "ADAPT BEHAVIOR TX PHYS/QHP", "code_information": [{"code": "97155", "type": "CPT"}], "standard_charges": [{"minimum": 174.2, "maximum": 355.52, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 182.2, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 247.49, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 177.76, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 183.09, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 177.76, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 174.2, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 186.65, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 355.52, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 181.32, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 177.76, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 181.32, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPT BHV TX EA 15 MIN", "code_information": [{"code": "373T", "type": "CPT"}], "standard_charges": [{"minimum": 36.77, "maximum": 75.04, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 38.46, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 52.25, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 37.52, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 38.65, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 37.52, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 36.77, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 39.4, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 75.04, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 38.27, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 37.52, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 38.27, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPT/EXT, PACING/NEURO LEAD", "code_information": [{"code": "C1883", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPT/EXT, PACING/NEURO LEAD", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "275", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPT/EXT, PACING/NEURO LEAD", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "278", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPTIVE BEHAVIOR TX BY TECH", "code_information": [{"code": "97153", "type": "CPT"}], "standard_charges": [{"minimum": 99.71, "maximum": 203.48, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 104.28, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 141.65, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 104.79, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 99.71, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 106.83, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 203.48, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 103.77, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 103.77, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD 30 MINS COUNSEL", "code_information": [{"code": "G2080", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD CLASP TO PARTIAL DENTURE", "code_information": [{"code": "D5660", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD METAL SUB TO ACRYLC DENT", "code_information": [{"code": "D5876", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD PROC CONSTRUCT NEW CROWN", "code_information": [{"code": "D2971", "type": "HCPCS"}], "standard_charges": [{"minimum": 634.5, "maximum": 1560.2, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 663.64, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 1560.2, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 647.45, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 666.87, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 647.45, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 634.5, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 679.82, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1294.9, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 660.4, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 647.45, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 660.4, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD TO SPINAL ORTHOSIS NOS", "code_information": [{"code": "L0999", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD TOOTH TO PARTIAL DENTURE", "code_information": [{"code": "D5650", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}], "standard_charges": [{"minimum": 159.49, "maximum": 7438.96, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 166.81, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 7438.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 392.18, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 162.74, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 167.62, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 162.74, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 159.49, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 170.88, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 325.48, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 165.99, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 162.74, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 361.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 165.99, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITIVE FOR ENTERAL FORMULA", "code_information": [{"code": "B4104", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDL SUPL MATRL&STAF TM PHE", "code_information": [{"code": "99072", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOMA DETECTED SCREENING", "code_information": [{"code": "3775F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOMA NOT DETECT SCREENING", "code_information": [{"code": "3776F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}], "standard_charges": [{"minimum": 0.56, "maximum": 0.56, "estimated_discounted_cash": 265.02, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_percentage": 57.0, "possible_amount": 220.81, "count": "1 through 10", "median_amount": 159.65, "methodology": "percent of total billed charges", "10th_percentile": 159.65, "90th_percentile": 281.97}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 0.56, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 265.02, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 265.02, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 265.02, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 265.02, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 265.02, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 265.02, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 265.02, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 55.2, "possible_amount": 110.01, "count": "1 through 10", "median_amount": 110.01, "methodology": "percent of total billed charges", "10th_percentile": 110.01, "90th_percentile": 110.01}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}], "standard_charges": [{"minimum": 11.74, "maximum": 28.87, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 12.28, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 28.87, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 11.98, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 12.34, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 11.98, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 11.74, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 12.58, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 23.96, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 12.22, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 11.98, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 12.22, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}], "standard_charges": [{"minimum": 14.14, "maximum": 34.76, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 14.79, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 34.76, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 14.43, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 14.86, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 14.43, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 14.14, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 15.15, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 28.86, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 14.72, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 14.43, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 14.72, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}], "standard_charges": [{"minimum": 12.61, "maximum": 31.01, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 13.19, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 31.01, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 12.87, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 13.26, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 12.87, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 12.61, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 13.51, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 25.74, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 13.13, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 12.87, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 13.13, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}], "standard_charges": [{"minimum": 21.32, "maximum": 52.45, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 22.3, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 52.45, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 21.76, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 22.41, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 21.76, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 21.32, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 22.85, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 43.52, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 22.2, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 21.76, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 22.2, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHERE TX ASSESS AT LST ANN", "code_information": [{"code": "G8851", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}], "standard_charges": [{"minimum": 3928.0, "maximum": 8582.93, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 8582.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3928.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESION BARRIER", "code_information": [{"code": "C1765", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESION BARRIER", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "275", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESION BARRIER", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "278", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIVE BANDAGE, FIRST-AID", "code_information": [{"code": "A6413", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADIT MDD DYS REM 12 MNTHS", "code_information": [{"code": "G9509", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}], "standard_charges": [{"minimum": 5102.0, "maximum": 17511.75, "estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 7448.72, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 5724.04, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 17511.75, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 7267.04, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 7485.05, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 7267.04, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 7121.7, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 7630.39, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 14534.08, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 7412.38, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 7267.04, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 5102.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 7412.38, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_percentage": 43.4, "possible_amount": 4083.77, "count": "1 through 10", "median_amount": 4083.77, "methodology": "percent of total billed charges", "10th_percentile": 4083.77, "90th_percentile": 4083.77}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 9345.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUNCTIVE PROCEDURE", "code_information": [{"code": "D9999", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUST MAX PROST APPLIANCE", "code_information": [{"code": "D5992", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUST SLEEP APNEA APPLIANCE", "code_information": [{"code": "D9948", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "270", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "271", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "272", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "273", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "274", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "275", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "276", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "277", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "278", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}, {"code": "279", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 44.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTMENT GASTRIC BAND", "code_information": [{"code": "S2083", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJV HRMNL THXPY RXD", "code_information": [{"code": "4164F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJV THXPYRXD/RCVD COLON CA", "code_information": [{"code": "4180F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJV TRTMT CHEMO HER2", "code_information": [{"code": "G2206", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADL PT MJ DEP DS NO RS 12 MO", "code_information": [{"code": "M1020", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADL PT MJ DEP DS RS 12 PHQ<5", "code_information": [{"code": "M1019", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADLT DISP UND/PULL ON ABV XL", "code_information": [{"code": "T4544", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM IV CHEMO 1ST HOME VISIT", "code_information": [{"code": "G0090", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM IV DRUG 1ST HOME VISIT", "code_information": [{"code": "G0088", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM IV INFUSION DRUG IN HOME", "code_information": [{"code": "G0068", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM OF CHEMO DRUG IN HOME", "code_information": [{"code": "G0070", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM OF SOC DTR ASSESS 5-15 M", "code_information": [{"code": "G0136", "type": "HCPCS"}], "standard_charges": [{"minimum": 36.77, "maximum": 90.43, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 38.46, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 90.43, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 37.52, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 38.65, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 37.52, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 36.77, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 39.4, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 75.04, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 38.27, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 37.52, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 38.27, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM SQ INFUSION DRUG IN HOME", "code_information": [{"code": "G0069", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM SUBQ DRUG 1ST HOME VISIT", "code_information": [{"code": "G0089", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 1ST", "code_information": [{"code": "M0249", "type": "HCPCS"}], "standard_charges": [{"minimum": 432.78, "maximum": 1064.16, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 452.65, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 1064.16, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 441.61, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 454.86, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 441.61, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 432.78, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 463.69, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 883.22, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 450.44, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 441.61, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 450.44, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 1ST", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "260", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 1ST", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "261", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 1ST", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "262", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 1ST", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "263", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 1ST", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "264", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 1ST", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "269", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 2ND", "code_information": [{"code": "M0250", "type": "HCPCS"}], "standard_charges": [{"minimum": 432.78, "maximum": 1064.16, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 452.65, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 1064.16, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 441.61, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 454.86, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 441.61, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 432.78, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 463.69, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 883.22, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 450.44, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 441.61, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 450.44, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 2ND", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "260", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 2ND", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "261", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 2ND", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "262", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 2ND", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "263", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 2ND", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "264", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 2ND", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "269", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 32.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN ECG CONTRAST AGENT", "code_information": [{"code": "93352", "type": "CPT"}], "standard_charges": [{"minimum": 31.4, "maximum": 36.47, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 31.4, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 31.4, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 36.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 31.4, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 31.4, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 35.46, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 31.4, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 35.46, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 36.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 36.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 35.46, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 31.4, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 35.46, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 36.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 36.47, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 36.47, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN ECG CONTRAST AGENT", "code_information": [{"code": "93352", "type": "CPT"}, {"code": "480", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN ECG CONTRAST AGENT", "code_information": [{"code": "93352", "type": "CPT"}, {"code": "481", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN ECG CONTRAST AGENT", "code_information": [{"code": "93352", "type": "CPT"}, {"code": "482", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN ECG CONTRAST AGENT", "code_information": [{"code": "93352", "type": "CPT"}, {"code": "483", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN ECG CONTRAST AGENT", "code_information": [{"code": "93352", "type": "CPT"}, {"code": "489", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.7, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.1, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN HEPATITIS B VACCINE", "code_information": [{"code": "G0010", "type": "HCPCS"}], "standard_charges": [{"minimum": 45.96, "maximum": 113.02, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 48.07, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 113.02, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 48.31, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 45.96, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 49.25, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 93.8, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 47.84, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 47.84, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN HOME SLEEP APNEA TEST", "code_information": [{"code": "D9956", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN INFLUENZA VIRUS VAC", "code_information": [{"code": "G0008", "type": "HCPCS"}], "standard_charges": [{"minimum": 45.96, "maximum": 113.02, "estimated_discounted_cash": 91.92, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 48.07, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 113.02, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 22.09, "count": "1 through 10", "median_amount": 22.09, "methodology": "percent of total billed charges", "10th_percentile": 22.09, "90th_percentile": 22.09}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_percentage": 21.42, "possible_amount": 22.61, "count": "1 through 10", "median_amount": 23.39, "methodology": "percent of total billed charges", "10th_percentile": 21.05, "90th_percentile": 23.39}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 48.31, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 45.96, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 49.25, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 93.8, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 47.84, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 22.09, "count": "1 through 10", "median_amount": 22.09, "methodology": "percent of total billed charges", "10th_percentile": 22.09, "90th_percentile": 22.09}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 47.84, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN PNEUMOCOCCAL VACCINE", "code_information": [{"code": "G0009", "type": "HCPCS"}], "standard_charges": [{"minimum": 45.96, "maximum": 113.02, "estimated_discounted_cash": 91.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 48.07, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 113.02, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 48.31, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 45.96, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 49.25, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 93.8, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 47.84, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 46.9, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 47.84, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMISSION TO MCCM", "code_information": [{"code": "G9480", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIT W/IN 180D REQ REMOV", "code_information": [{"code": "G9410", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIT W/IN 180D REQ SURG REV", "code_information": [{"code": "G9412", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMN RSV MONOC ANTB IM CNSL", "code_information": [{"code": "96380", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMN SARSCOV2 VACC 1 DOSE", "code_information": [{"code": "90480", "type": "CPT"}], "standard_charges": [{"minimum": 39.89, "maximum": 98.08, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 41.72, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 98.08, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 40.7, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 41.92, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 40.7, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 39.89, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 42.74, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 81.4, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 41.51, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 40.7, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 41.51, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADOPTIVE IMMUNOTHERAPY", "code_information": [{"code": "S2107", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADR DEP THRPY PRESCRIBED", "code_information": [{"code": "G9894", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRC THER PRTL RC TEAR", "code_information": [{"code": "717T", "type": "CPT"}], "standard_charges": [{"minimum": 3478.03, "maximum": 8552.23, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 3637.74, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 5724.04, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 8552.23, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 3549.01, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 3655.48, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 3549.01, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 3478.03, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 3726.46, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 7098.02, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 3619.99, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 3549.01, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 5102.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 3619.99, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRC THER PRTL RC TEAR NJX", "code_information": [{"code": "718T", "type": "CPT"}], "standard_charges": [{"minimum": 3478.03, "maximum": 8552.23, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 3637.74, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 3706.93, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 8552.23, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 3549.01, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 3655.48, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 3549.01, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 3478.03, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 3726.46, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 7098.02, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 3619.99, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 3549.01, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 5102.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 3619.99, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC", "code_information": [{"code": "614", "type": "MS-DRG"}], "standard_charges": [{"minimum": 12513.99, "maximum": 51406.48, "estimated_discounted_cash": 117939.69, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 19651.15, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 33150.98, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 37385.11, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 17166.37, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 27529.01, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 19171.85, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 27529.01, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 35073.18, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 35073.18, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 24109.8, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 16829.78, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 24592.0, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 38163.62, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 19747.01, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 19171.85, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 20130.44, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 16829.78, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 38343.7, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 12513.99, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 19171.85, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 51406.48, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 17166.37, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 19555.29, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 17166.37, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC", "code_information": [{"code": "615", "type": "MS-DRG"}], "standard_charges": [{"minimum": 7989.25, "maximum": 32819.18, "estimated_discounted_cash": 56524.47, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 12545.78, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 21164.41, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 23867.59, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 16348.33, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 17575.21, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 12239.79, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 17575.21, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 22391.6, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 22391.6, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 15392.3, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 16027.78, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 15700.15, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 24364.61, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 12606.98, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 12239.79, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 12851.78, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 16027.78, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 24479.58, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 7989.25, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 12239.79, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 32819.18, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 16348.33, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 12484.59, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 16348.33, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ADRENAL CORTEX & MEDULLA IMG", "code_information": [{"code": "78075", "type": "CPT"}], "standard_charges": [{"minimum": 341.02, "maximum": 3124.44, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 1328.99, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 3124.44, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 341.02, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 341.02, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 396.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 341.02, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 341.02, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 385.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 341.02, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 385.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 396.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 396.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 385.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 341.02, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 385.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 396.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 396.03, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 396.03, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1296.58, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 1335.48, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1296.58, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1270.65, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 1361.41, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 2593.16, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1322.51, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1296.58, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1322.51, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL CORTEX & MEDULLA IMG", "code_information": [{"code": "78075", "type": "CPT"}, {"code": "340", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL CORTEX & MEDULLA IMG", "code_information": [{"code": "78075", "type": "CPT"}, {"code": "341", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL CORTEX & MEDULLA IMG", "code_information": [{"code": "78075", "type": "CPT"}, {"code": "342", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL CORTEX & MEDULLA IMG", "code_information": [{"code": "78075", "type": "CPT"}, {"code": "343", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL CORTEX & MEDULLA IMG", "code_information": [{"code": "78075", "type": "CPT"}, {"code": "344", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL CORTEX & MEDULLA IMG", "code_information": [{"code": "78075", "type": "CPT"}, {"code": "349", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 38.6, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 49.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL TISSUE TRANSPLANT", "code_information": [{"code": "S2103", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}], "standard_charges": [{"minimum": 1279.26, "maximum": 3145.61, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 1338.0, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 3145.61, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 1305.37, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 1344.53, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 1305.37, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 1279.26, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 1370.64, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 2610.74, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 1331.48, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 1305.37, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 1331.48, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADT 180 DYS PHARMTHRY OUD", "code_information": [{"code": "M1034", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADT NO 180 DYS PHARMTHRY OUD", "code_information": [{"code": "M1036", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADT PD OUT MAT PR 180 DYS TX", "code_information": [{"code": "M1035", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADT TKNG PHARMTHRY FOR OUD", "code_information": [{"code": "M1032", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT COMPANIONCARE PER 15M", "code_information": [{"code": "S5135", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT COMPANIONCARE PER DIEM", "code_information": [{"code": "S5136", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT DAY CARE PER DIEM", "code_information": [{"code": "S5102", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT DAY CARE PER HALF DAY", "code_information": [{"code": "S5101", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT DAYCARE SERVICES 15MIN", "code_information": [{"code": "S5100", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT DISP BRIEF/DIAP ABV XL", "code_information": [{"code": "T4543", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT FOSTER CARE PER DIEM", "code_information": [{"code": "S5140", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT FOSTER CARE PER MONTH", "code_information": [{"code": "S5141", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE BRIEF/DIAPER LG", "code_information": [{"code": "T4523", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE BRIEF/DIAPER MED", "code_information": [{"code": "T4522", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE BRIEF/DIAPER SM", "code_information": [{"code": "T4521", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE BRIEF/DIAPER XL", "code_information": [{"code": "T4524", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE PULL-ON LG", "code_information": [{"code": "T4527", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE PULL-ON MED", "code_information": [{"code": "T4526", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE PULL-ON SM", "code_information": [{"code": "T4525", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE PULL-ON XL", "code_information": [{"code": "T4528", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SPEECH AID", "code_information": [{"code": "D5953", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADV CARE HEART DX MVP", "code_information": [{"code": "G0055", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADV DEM CRGVR LIMITED", "code_information": [{"code": "G9917", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADV RHEUM PT CARE MVP", "code_information": [{"code": "G0053", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVANCED LIFE SUPPORT MILEAG", "code_information": [{"code": "A0390", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVANCING CANCER CARE MVP", "code_information": [{"code": "M0001", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVNC CARE PLAN IN RCRD", "code_information": [{"code": "1157F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVNC CARE PLAN TLK DOCD", "code_information": [{"code": "1158F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVNCD CARE PLAN 30 MIN", "code_information": [{"code": "99497", "type": "CPT"}], "standard_charges": [{"minimum": 99.71, "maximum": 245.16, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 104.28, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 245.16, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 104.79, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 99.71, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 106.83, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 203.48, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 103.77, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 101.74, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 103.77, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVNCD CARE PLAN ADDL 30 MIN", "code_information": [{"code": "99498", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP HEARING STATUS DETER I&R", "code_information": [{"code": "92651", "type": "CPT"}], "standard_charges": [{"minimum": 211.93, "maximum": 521.1, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 221.66, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 521.1, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 222.74, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 211.93, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 227.06, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 432.5, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 220.58, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 220.58, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP HEARING STATUS DETER I&R", "code_information": [{"code": "92651", "type": "CPT"}, {"code": "470", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP HEARING STATUS DETER I&R", "code_information": [{"code": "92651", "type": "CPT"}, {"code": "471", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP HEARING STATUS DETER I&R", "code_information": [{"code": "92651", "type": "CPT"}, {"code": "472", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP HEARING STATUS DETER I&R", "code_information": [{"code": "92651", "type": "CPT"}, {"code": "479", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP NEURODIAGNOSTIC I&R", "code_information": [{"code": "92653", "type": "CPT"}], "standard_charges": [{"minimum": 211.93, "maximum": 521.1, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 221.66, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 521.1, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 222.74, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 211.93, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 227.06, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 432.5, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 220.58, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 220.58, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP NEURODIAGNOSTIC I&R", "code_information": [{"code": "92653", "type": "CPT"}, {"code": "470", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP NEURODIAGNOSTIC I&R", "code_information": [{"code": "92653", "type": "CPT"}, {"code": "471", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP NEURODIAGNOSTIC I&R", "code_information": [{"code": "92653", "type": "CPT"}, {"code": "472", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP NEURODIAGNOSTIC I&R", "code_information": [{"code": "92653", "type": "CPT"}, {"code": "479", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP SCR AUDITORY POTENTIAL", "code_information": [{"code": "92650", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP SCR AUDITORY POTENTIAL", "code_information": [{"code": "92650", "type": "CPT"}, {"code": "470", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP SCR AUDITORY POTENTIAL", "code_information": [{"code": "92650", "type": "CPT"}, {"code": "471", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP SCR AUDITORY POTENTIAL", "code_information": [{"code": "92650", "type": "CPT"}, {"code": "472", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP SCR AUDITORY POTENTIAL", "code_information": [{"code": "92650", "type": "CPT"}, {"code": "479", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP THRSHLD EST MLT FREQ I&R", "code_information": [{"code": "92652", "type": "CPT"}], "standard_charges": [{"minimum": 211.93, "maximum": 521.1, "estimated_discounted_cash": 6312.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 221.66, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 521.1, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 222.74, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 211.93, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 227.06, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 432.5, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 220.58, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 216.25, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 220.58, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 1532.31, "count": "1 through 10", "median_amount": 1532.31, "methodology": "percent of total billed charges", "10th_percentile": 1532.31, "90th_percentile": 1532.31}], "billing_class": "facility"}]}, {"description": "AEP THRSHLD EST MLT FREQ I&R", "code_information": [{"code": "92652", "type": "CPT"}, {"code": "470", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 6312.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP THRSHLD EST MLT FREQ I&R", "code_information": [{"code": "92652", "type": "CPT"}, {"code": "471", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 6312.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP THRSHLD EST MLT FREQ I&R", "code_information": [{"code": "92652", "type": "CPT"}, {"code": "472", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 6312.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP THRSHLD EST MLT FREQ I&R", "code_information": [{"code": "92652", "type": "CPT"}, {"code": "479", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 6312.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.3, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEROSOL INHALATION TREATMENT", "code_information": [{"code": "94642", "type": "CPT"}], "standard_charges": [{"minimum": 25.8, "maximum": 528.46, "estimated_discounted_cash": 509.67, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 224.78, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 528.46, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "standard_charge_dollar": 25.8, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "standard_charge_dollar": 25.8, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "standard_charge_dollar": 29.97, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "standard_charge_dollar": 25.8, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "standard_charge_dollar": 25.8, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "standard_charge_dollar": 29.13, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "standard_charge_dollar": 25.8, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "standard_charge_dollar": 29.13, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "standard_charge_dollar": 29.97, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "standard_charge_dollar": 29.97, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "standard_charge_dollar": 29.13, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "standard_charge_dollar": 25.8, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "standard_charge_dollar": 29.13, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "standard_charge_dollar": 29.97, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "standard_charge_dollar": 29.97, "methodology": "fee schedule"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "standard_charge_dollar": 29.97, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 219.3, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 225.88, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 219.3, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 214.91, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 230.27, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 438.6, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 223.69, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 219.3, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 223.69, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEROSOL INHALATION TREATMENT", "code_information": [{"code": "94642", "type": "CPT"}, {"code": "410", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 509.67, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEROSOL INHALATION TREATMENT", "code_information": [{"code": "94642", "type": "CPT"}, {"code": "412", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 509.67, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEROSOL INHALATION TREATMENT", "code_information": [{"code": "94642", "type": "CPT"}, {"code": "413", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 509.67, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEROSOL INHALATION TREATMENT", "code_information": [{"code": "94642", "type": "CPT"}, {"code": "419", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 509.67, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}], "standard_charges": [{"minimum": 2827.61, "maximum": 6952.88, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 2957.45, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 6952.88, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 2885.32, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 2971.88, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 2885.32, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 2827.61, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 3029.59, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 5770.64, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 2943.03, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 2885.32, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 3590.97, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 2943.03, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"minimum": 5954.59, "maximum": 5954.59, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"minimum": 5954.59, "maximum": 5954.59, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"minimum": 5954.59, "maximum": 5954.59, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"minimum": 5954.59, "maximum": 5954.59, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"minimum": 5954.59, "maximum": 5954.59, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"minimum": 5954.59, "maximum": 5954.59, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"minimum": 5954.59, "maximum": 5954.59, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 5954.59, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}], "standard_charges": [{"minimum": 134.26, "maximum": 330.14, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 140.43, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 330.14, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 137.0, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 141.11, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 137.0, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 134.26, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 143.85, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 274.0, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 139.74, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 137.0, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 139.74, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}], "standard_charges": [{"minimum": 269.33, "maximum": 662.27, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 281.7, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 662.27, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 283.07, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 269.33, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 288.57, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 549.66, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 280.33, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 274.83, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 280.33, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}], "standard_charges": [{"minimum": 122.14, "maximum": 300.33, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 127.75, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 300.33, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 128.37, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 122.14, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 130.86, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 249.26, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 124.63, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 286.91, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 127.12, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}], "standard_charges": [{"minimum": 741.2, "maximum": 1822.57, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 775.24, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 1822.57, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 756.33, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 779.02, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 756.33, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 741.2, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 794.15, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1512.66, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 771.46, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 756.33, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 963.85, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 771.46, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"minimum": 1432.55, "maximum": 1432.55, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"minimum": 1432.55, "maximum": 1432.55, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"minimum": 1432.55, "maximum": 1432.55, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"minimum": 1432.55, "maximum": 1432.55, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"minimum": 1432.55, "maximum": 1432.55, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"minimum": 1432.55, "maximum": 1432.55, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"minimum": 1432.55, "maximum": 1432.55, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 1432.55, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}], "standard_charges": [{"minimum": 31.4, "maximum": 31.4, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 31.4, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}], "standard_charges": [{"minimum": 539.8, "maximum": 4951.29, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 564.59, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 4951.29, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 1327.34, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 550.82, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 567.34, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 550.82, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 539.8, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 578.36, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1101.64, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 561.84, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 550.82, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 905.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 561.84, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "360", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "361", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "362", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "367", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "369", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 34.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.4, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "490", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "499", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "750", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "761", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "790", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTERCARE WITH CC/MCC", "code_information": [{"code": "949", "type": "MS-DRG"}], "standard_charges": [{"minimum": 6792.54, "maximum": 27903.22, "estimated_discounted_cash": 55167.57, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 10666.56, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 17994.21, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 20292.48, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 22462.09, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 14942.63, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 10406.4, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 14942.63, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 19037.58, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 19037.58, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 13086.7, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 22021.66, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 13348.43, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 20715.06, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 10718.59, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 10406.4, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 10926.72, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 22021.66, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 20812.8, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 6792.54, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 10406.4, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 27903.22, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 22462.09, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 10614.53, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 22462.09, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFTERCARE WITHOUT CC/MCC", "code_information": [{"code": "950", "type": "MS-DRG"}], "standard_charges": [{"minimum": 3583.83, "maximum": 14722.08, "estimated_discounted_cash": 11653.68, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 5627.8, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 9493.96, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 10706.55, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 14708.43, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 7883.91, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 5490.54, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 7883.91, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 10044.46, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 10044.46, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 6904.7, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 14420.03, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 7042.79, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 10929.51, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 5655.26, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 5490.54, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 5765.07, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 14420.03, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 10981.08, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 3583.83, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 5490.54, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 14722.08, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 14708.43, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 5600.35, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 14708.43, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC", "code_information": [{"code": "560", "type": "MS-DRG"}], "standard_charges": [{"minimum": 6429.42, "maximum": 26411.55, "estimated_discounted_cash": 28118.12, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 10096.34, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 17032.26, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 19207.68, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 14138.19, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 14143.82, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 9850.09, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 14143.82, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 18019.85, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 18019.85, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 12387.1, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 13860.97, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 12634.84, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 19607.65, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 10145.59, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 9850.09, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 10342.59, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 13860.97, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 19700.18, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 6429.42, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 9850.09, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 26411.55, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 14138.19, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 10047.09, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 14138.19, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC", "code_information": [{"code": "559", "type": "MS-DRG"}], "standard_charges": [{"minimum": 10647.57, "maximum": 43739.36, "estimated_discounted_cash": 29538.54, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 16720.24, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 28206.61, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 31809.24, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 19368.85, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 23423.14, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 16312.43, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 23423.14, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 29842.13, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 29842.13, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 20513.9, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 18989.07, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 20924.18, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 32471.64, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 16801.8, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 16312.43, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 17128.05, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 18989.07, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 32624.86, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 10647.57, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 16312.43, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 43739.36, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 19368.85, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 16638.68, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 19368.85, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC", "code_information": [{"code": "561", "type": "MS-DRG"}], "standard_charges": [{"minimum": 4589.83, "maximum": 18854.67, "estimated_discounted_cash": 18907.99, "setting": "inpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 7207.57, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "standard_charge_dollar": 12158.99, "methodology": "case rate"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 13711.97, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_dollar": 12542.3, "methodology": "fee schedule"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 10096.98, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 7031.78, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 10096.98, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 12864.01, "methodology": "case rate"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 12864.01, "methodology": "case rate"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "standard_charge_dollar": 8842.9, "methodology": "case rate"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "standard_charge_dollar": 12296.37, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "ACA", "standard_charge_dollar": 9019.76, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 13997.51, "methodology": "case rate"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 7242.73, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 7031.78, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 24.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 29.24, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 7383.37, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "standard_charge_dollar": 12296.37, "methodology": "fee schedule"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 14063.56, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 4589.83, "methodology": "case rate"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 7031.78, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 18854.67, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "standard_charge_dollar": 12542.3, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 7172.42, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "standard_charge_dollar": 12542.3, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}], "standard_charges": [{"minimum": 11.74, "maximum": 28.87, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 12.28, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 28.87, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 11.98, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 12.34, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 11.98, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 11.74, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 12.58, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 23.96, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 12.22, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 11.98, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 12.22, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}], "standard_charges": [{"minimum": 221.1, "maximum": 543.65, "estimated_discounted_cash": 31292.58, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 231.25, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 543.65, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "standard_charge_percentage": 21.85, "possible_amount": 7596.59, "count": "1 through 10", "median_amount": 1587.76, "methodology": "percent of total billed charges", "10th_percentile": 1587.76, "90th_percentile": 13605.41}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 225.61, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 57.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 232.38, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 225.61, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 221.1, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 236.89, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 451.22, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 230.12, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 225.61, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "standard_charge_dollar": 280.92, "methodology": "fee schedule"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 230.12, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"minimum": 389.98, "maximum": 389.98, "estimated_discounted_cash": 31292.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"minimum": 389.98, "maximum": 389.98, "estimated_discounted_cash": 31292.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"minimum": 389.98, "maximum": 389.98, "estimated_discounted_cash": 31292.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"minimum": 389.98, "maximum": 389.98, "estimated_discounted_cash": 31292.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"minimum": 389.98, "maximum": 389.98, "estimated_discounted_cash": 31292.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"minimum": 389.98, "maximum": 389.98, "estimated_discounted_cash": 31292.58, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"minimum": 389.98, "maximum": 389.98, "estimated_discounted_cash": 31292.58, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "standard_charge_dollar": 389.98, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}], "standard_charges": [{"minimum": 15.75, "maximum": 38.72, "estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 16.47, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 38.72, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 16.07, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 16.55, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 16.07, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 15.75, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 16.87, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 32.14, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 16.39, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 16.07, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 16.39, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"estimated_discounted_cash": 227.0, "setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}], "standard_charges": [{"minimum": 6.84, "maximum": 16.83, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 7.15, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 16.83, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 6.98, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 7.19, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 6.98, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 6.84, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 7.33, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 13.96, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 7.12, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 6.98, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 7.12, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}, {"code": "631", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}, {"code": "632", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}, {"code": "633", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}, {"code": "634", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}, {"code": "635", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}, {"code": "636", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}, {"code": "637", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 43.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 55.2, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AHI OR RDI INITIAL DX", "code_information": [{"code": "G8842", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 30.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 51.8, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}], "standard_charges": [{"minimum": 823.84, "maximum": 2025.77, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 861.67, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 2025.77, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 840.65, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 865.87, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 840.65, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 823.84, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 882.68, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1681.3, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 857.46, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 840.65, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 857.46, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "312", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "314", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}, {"code": "319", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}], "standard_charges": [{"minimum": 744.8, "maximum": 1831.41, "setting": "outpatient", "payers_information": [{"payer_name": "Aetna", "plan_name": "Broad Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "First Health", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Medicare", "standard_charge_dollar": 779.0, "methodology": "fee schedule"}, {"payer_name": "Aetna", "plan_name": "NC Preferred Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 63.3, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Aetna", "plan_name": "Rental Network Products", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Ambetter", "plan_name": "All Plans", "standard_charge_dollar": 1831.41, "methodology": "fee schedule"}, {"payer_name": "AmeriHealth", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Atlantic Corporation DBA Atlantic Packaging", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 50.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Advantage65", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueCare", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueChoice", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueMedicare PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueOptions", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "BlueSelect", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "CoverFL", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Essential Network", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "FEP", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "GoBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 62.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "NetworkBlue", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPC", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "BCBSFL", "plan_name": "Traditional (PPSPHS)", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 72.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Medicare", "standard_charge_dollar": 760.0, "methodology": "fee schedule"}, {"payer_name": "Caresource North Carolina", "plan_name": "Qualified Health Plan", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 40.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Carolina Complete", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "ACA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 39.2, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "HealthSpring", "standard_charge_dollar": 782.8, "methodology": "fee schedule"}, {"payer_name": "Employers Choice Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 86.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Humana", "plan_name": "Medicare", "standard_charge_dollar": 760.0, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "Tricare Federal Services", "standard_charge_dollar": 744.8, "methodology": "fee schedule"}, {"payer_name": "Humana Military", "plan_name": "VA", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.64, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Liberty Health", "plan_name": "Medicare HMO", "standard_charge_dollar": 798.0, "methodology": "fee schedule"}, {"payer_name": "Medcost", "plan_name": "MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 65.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Medcost", "plan_name": "non-MBS", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 70.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Multiplan", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Medicaid eligible Offenders", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.42, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "NC Department of Public Safety", "plan_name": "Offenders Not Medicaid eligible", "standard_charge_dollar": 1520.0, "methodology": "fee schedule"}, {"payer_name": "New Hanover Health", "plan_name": "All Plans", "standard_charge_dollar": 775.2, "methodology": "fee schedule"}, {"payer_name": "Pace of the Southern Piedmont", "plan_name": "All Plans", "standard_charge_dollar": 760.0, "methodology": "fee schedule"}, {"payer_name": "Phcs", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Plotkin Health", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 60.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Three Rivers Provider Network", "plan_name": "All Plans", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 97.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "All Payer", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 58.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "United Healthcare", "plan_name": "Medicare", "standard_charge_dollar": 775.2, "methodology": "fee schedule"}, {"payer_name": "Wellcare", "plan_name": "Medicaid", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 21.85, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "300", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "301", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "302", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "303", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "304", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "305", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "306", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "307", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "309", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Blue Cross NC", "plan_name": "Blue Home", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "Blue Value", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 41.5, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "HMO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross NC", "plan_name": "PPO", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 52.9, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "310", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 56.9, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}, {"code": "311", "type": "RC"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found f